Communicable diseases are capable of being transmitted from one person to another, or from one species to another. Two major groups of communicable diseases, classified in the ICD-10, are certain infectious and parasitic diseases (ICD-10 codes A00-B99) and acute respiratory infections (ICD-10 codes J00-J22) which includes influenza and pneumonia as well as other acute upper and lower respiratory infections. In 2007, these two groups accounted for 3.4% of all deaths in Australia (4,641 deaths). Influenza and pneumonia accounted for 57% (2,623) of these deaths. Death rates increased with age, and were greater for males than females in most age groups. In 2007-08, there were 91,273 hospital separations in Australia with a principal diagnosis of infectious and parasitic diseases.

Through the National Notifiable Diseases Surveillance System (NNDSS), state and territory health authorities submit reports of more than 60 communicable disease notifications for compilation by the Department of Health and Ageing.

The total of notifications to NNDSS in 2008 was 160,498, an increase of 9.1% on the 147,555 notifications made in 2007 (table 11.20). In 2008, sexually transmitted infections (STI) were the most commonly reported communicable diseases, accounting for 43% of all notifications, followed by vaccine preventable diseases (21%) and gastrointestinal diseases (17%).

Chlamydia was the most common STI (58,515 notifications, 84% of total STIs); campylobacteriosis the most common gastroenteritis (15,533 notifications, 57% of total) and hepatitis C (unspecified) was the most common blood-borne disease (10,932 notifications, 60% of total).

11.20 NATIONAL NOTIFIABLE DISEASE SURVEILLANCE SYSTEM (NNDSS) REPORTS

NOTIFICATIONS

RATE(a)

Disease(b)

2007

2008

2007

2008

Bloodborne diseases

Hepatitis B (incident)

294

245

1

1

Hepatitis B (unspecified)

6 883

6 591

33

31

Hepatitis C (incident)

384

385

2

2

Hepatitis C (unspecified)

11 906

10 932

57

51

Hepatitis D

34

43

-

-

Hepatitis (NEC)

-

1

-

-

Gastrointestinal diseases

Botulism

1

-

-

-

Campylobacteriosis

16 997

15 533

120

108

Cryptosporidiosis

2 812

2 005

13

9

Haemolytic uraemic syndrome (HUS)

19

31

-

-

Hepatitis A

165

277

1

1

Hepatitis E

18

44

-

-

Listeriosis

50

68

-

-

STEC, VTEC(c)

106

107

1

1

Salmonellosis

9 534

8 313

45

39

Shigellosis

602

829

3

4

Typhoid

90

105

-

1

Other bacterial infections

Legionellosis

306

273

2

1

Leprosy

13

11

-

-

Meningococcal disease (invasive)

306

285

2

1

Tuberculosis

1 174

1 225

6

6

Quarantinable diseases

Cholera

4

4

-

-

Plague

-

-

-

-

Rabies

-

-

-

-

Smallpox

-

-

-

-

Viral haemorrhagic fever (NEC)

-

-

-

-

Yellow fever

-

-

-

-

Sexually transmissible infections

Chlamydial infection

52 043

58 515

248

274

Donovanosis

3

2

-

-

Gonococcal infection

7 677

7 675

37

36

Syphilis

-

-

-

-

Syphilis - congenital

7

7

-

-

Syphilis < 2 years duration

1 422

1 298

7

6

Syphilis > 2 years or unspecified duration

1 740

1 940

8

9

Vaccine preventable diseases

Diphtheria

-

-

-

-

Haemophilus influenzae type b

17

25

-

-

Influenza (laboratory confirmed)

10 448

9 136

50

43

Measles

12

65

-

-

Mumps

586

286

3

1

Pertussis

5 347

14 524

25

68

Pneumococcal disease (invasive)

1 483

1 629

7

8

Poliomyelitis

1

-

-

-

Rubella

34

37

-

-

Rubella Congenital

2

-

-

-

Tetanus

3

4

-

-

Varicella zoster (Chickenpox)

1 668

1 790

8

8

Varicella zoster (Shingles)

1 561

2 313

7

11

Varicella zoster (Unspecified)

4 287

4 426

20

21

Vectorborne diseases

Arbovirus infection (NEC)

22

28

-

-

Barmah Forest virus infection

1 716

2 101

8

10

Chikungunya virus infection

-

9

-

-

Dengue virus infection

314

559

2

3

Japanese encephalitis virus infection

-

1

-

-

Kunjin virus infection

1

1

-

-

Malaria

568

532

3

3

Murray Valley encephalitis virus infection

-

2

-

-

Ross River virus infection

4 207

5 651

20

26

Zoonoses

Anthrax

1

-

-

-

Australian bat lyssavirus

-

-

-

-

Brucellosis

38

47

-

-

Leptospirosis

108

112

1

1

Lyssavirus (NEC)

-

-

-

-

Ornithosis

93

103

-

1

Q fever

448

373

2

2

Tularaemia

-

-

-

-

Total

147 555

160 498

702

751

- nil or rounded to zero (including null cells)

(a) Rate per 100,000 population is calculated using the ERP at the midpoint of 2007-08.

(b) Diseases reported to NNDSS from all jurisdictions except incident Hepatitis C not reported from QLD; campylobacteriosis not reported from NSW.

In collaboration with the state and territory health authorities and the Australian Government, surveillance for human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) is conducted by the National Centre in HIV Epidemiology and Clinical Research. This centre is part of the Faculty of Medicine, University of New South Wales and is funded primarily by the Department of Health and Ageing (DoHA).

At 31 December 2008, the cumulative number of cases of newly diagnosed HIV infections since 1985 was 28,330 (table 11.21). The average number of new HIV cases diagnoses from 2004-2008 was 984 per year.

(a) Not adjusted for multiple reporting. Cumulative to 31 December 2008.

(b) Number of AIDS cases diagnosed in NSW in 2008 are not available and not included in Totals.

(c) The number of HIV/AIDS diagnoses for each year may be revised over time due to late reports, updated information on exposure and testing history for reported cases, and removal of previously unrecognised duplicate diagnoses.

(d) Includes all cases reported prior to 2004

Source: HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2009', National Centre in HIV Epidemiology and Clinical Research, University of New South Wales; Australian Institute of Health and Welfare.

Transmission of HIV in Australia continues to be mainly through sexual contact between men, 66% in 2008, however, the rate of exposure through heterosexual contact has risen from 19.3% in 2005 to 27.1% in 2008 (table 11.22).

11.22 CHARACTERISTICS OF CASES OF NEWLY DIAGNOSED HIV INFECTION(a), Number of cases and proportion of total cases

YEAR OF DIAGNOSES(a)

2004

2005

2006

2007

2008

Total(b)

Total cases

no.

911.0

962.0

1 007.0

1 046.0

995.0

28 330

Males

%

86.0

90.2

85.3

87.0

86.3

91.3

State and territory

New South Wales

%

45.1

42.2

39.1

39.7

36.6

54.3

Victoria

%

23.6

26.7

28.4

27.3

28.6

22.0

Queensland

%

17.2

17.6

16.4

18.7

20.2

12.0

South Australia

%

5.9

5.3

6.1

5.4

4.7

4.0

Western Australia

%

5.5

6.6

7.6

7.2

7.6

5.6

Tasmania

%

1.0

0.6

0.7

0.5

0.4

0.4

Northern Territory

%

0.9

0.3

1.1

0.5

1.1

0.6

Australian Capital Territory

%

0.8

0.7

0.6

0.9

0.7

1.1

Exposure category(c)

Male homosexual contact

%

67.5

72.3

67.6

68.4

66.0

75.7

Male homosexual contact and injecting drug use

%

4.0

4.3

3.9

2.8

3.2

4.3

Injecting drug use(d)

%

4.4

3.4

2.8

2.9

3.1

4.0

Heterosexual contact

%

23.8

19.3

25.0

24.9

27.1

13.5

Haemophilia/coagulation disorder

%

-

-

-

-

-

1.2

Receipt of blood/tissue

%

0.1

0.1

-

-

0.1

1.0

Mother with/at risk of HIV infection

%

0.1

0.6

0.6

0.9

0.6

0.4

Health care setting

%

0.1

-

-

-

-

-

Other/undetermined

%

6.9

8.5

6.8

6.4

4.8

13.9

- nil or rounded to zero (including null cells)

(a) The number of HIV/AIDS diagnoses for each year may be revised over time due to late reports, updated information on exposure and testing history for reported cases, and removal of previously unrecognised duplicate diagnoses.

(b) Includes all reported cases prior to 2004. Not adjusted for multiple reporting.

(c) The ‘Other/undetermined’ category was excluded from the calculation of the percentage of cases attributed to each HIV exposure category.

(d) Excludes males who also reported a history of homosexual/bisexual contact.

Source: 'HIV and AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2009', National Centre in HIV Epidemiology and Clinical Research, University of New South Wales; Australian Institute of Health and Welfare.

According to the National Centre in HIV Epidemiology and Clinical Research, the per capita rate of HIV and AIDS diagnosis in Australia from 2003-2007 was at least five times higher among people born in countries in sub-Saharan Africa than among Australian born people. In the past five years, 60% of cases of HIV infection attributed to heterosexual contact were in people from high HIV prevalence countries or their sexual partners.

Immunisation programs for children are recognised as an effective public health intervention, and have been responsible for eradicating or minimising infectious diseases such as diphtheria, whooping cough and polio as major causes of death and disability in Australia.

The Australian Childhood Immunisation Register (ACIR), which commenced operation on 1 January 1996, aims to provide accurate and comprehensive information about immunisation coverage for all children under the age of seven. The register is administered by Medicare Australia and is a key component of initiatives to improve the immunisation status of Australian children.

Immunisation coverage goals for Australia for the year 2000, recommended by the NHMRC, called for 90% or more coverage of children at two years of age, and near universal coverage of children at school-entry age, against diphtheria, tetanus, pertussis (whooping cough), poliomyelitis, measles, mumps, rubella and Hib (Haemophilus influenza type b).

ACIR data indicated, at 31 December 2008, 92% of one year olds, 93% of two year olds (see graph 11.23) and 89% of six year olds were fully immunised according to the NHMRC Recommended Australian Standard Vaccination Schedule.

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